PDF
Word
Form 1500 Health Insurance Claim Form
What Is Form CMS-1500?
This is a legal form that was released by the U.S. Department of Health and Human Services - Centers for Medicare and Medicaid Services on February 1, 2012 and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is the CMS-1500 Health Insurance Claim Form?A: The CMS-1500 Health Insurance Claim Form is a standard form used to submit healthcare claims for services rendered to patients.
Q: Who uses the CMS-1500 Health Insurance Claim Form?A: Healthcare providers, such as doctors, hospitals, and clinics, use the CMS-1500 Health Insurance Claim Form to bill insurance companies for services provided to patients.
Q: What information is included on the CMS-1500 Health Insurance Claim Form?A: The CMS-1500 Health Insurance Claim Form includes information such as the patient's demographic details, diagnosis codes, procedures performed, and the provider's information.
Q: Is the CMS-1500 Health Insurance Claim Form used in both the US and Canada?A: No, the CMS-1500 Health Insurance Claim Form is used primarily in the United States. Canada has its own standard healthcare claim forms.
Form Details:
- Released on February 1, 2012;
- The latest available edition released by the U.S. Department of Health and Human Services - Centers for Medicare and Medicaid Services;
- Easy to use and ready to print;
- Yours to fill out and keep for your records;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form CMS-1500 by clicking the link below or browse more documents and templates provided by the U.S. Department of Health and Human Services - Centers for Medicare and Medicaid Services.
Download Form 1500 Health Insurance Claim Form
1
2
